The guidelines I follow are based on the current consensus through the American Academy of Family Physicians, the American Heart Association, UpToDate (the database I utilize on a daily basis), the US Preventative Task Force, and the American Diabetes Association. I work closely with a registered dietician in my clinic and I am a former medical librarian who specialized in medical literature research. That is to say, I do my best to provide the best evidence-based care and advice to my patients. Just as the recent recommendations to reduce BP upper range to 130/80 or reduce colonoscopy starting age to 45 does not change what we do in practice because it is not a consensus among the bodies mentioned above, recommendations on red meat and processed meat for practicing providers do not change based on one this recommendation. We’ve recently changed recommendations to forgo digital rectal exams, clinical breast exams, bimanual exams for uterine and ovarian cancer, annual Pap smears (in favor of Pap and HPV screening at 3-5 year intervals), annual mammograms (you can now perform them every 2 years.) So we do change practice, but it has to be guided by a consensus of guiding bodies, not a one recommendation.

There is evidence for reduced carbohydrate diet and reduced risk of diabetes, as well as reduced advancement of prediabetes to diabetes. I don’t strictly focus on reducing saturated fat when discussing nutrition and a healthful lifestyle. I talk about increasing physical activity, limiting alcohol, smoking cessation, reducing processed food and refined carbohydrates, increasing vegetables and fruits, increasing high fiber foods, increasing lean protein, reducing stress, sleep hygiene, adequate hydration and reduced sugary drinks. This is the best evidence-based advice I can currently give but certainly it may change as guidelines change.